Flashcards in Derm Deck (74):
If patient present with painful, tender, fluctuant, and erythematous nodule that eventually will have a bustle (may have spontaneous drainage or regional lymphadenopathy) - think?
Main causes of impetigo
- staph aureus, GABHS, MRSA
What is the most common symptom of folliculitis?
___ involvement would indicate severe SJS or TEN
mucosal (mouth, eyes)
HSP is most common before age ____ but can affect anyone.
papular, scaly, raised patch on skin with a circular border, think
Eczema is often colonized with what?
Discrete umbilicate papules, contents of papule may extrude with white cheesy material, dermatitis common around the lesion or impetigo
Treatment for abscess if MSSA? if MRSA?
MSSA = cephalexin
MRSA = SMX-TMP or clinda
Avoid what 2 drugs in herpes zoster?
aspirin and ibuprofen
this type of skin finding may occur when the immune system mistakenly attacks platelets. In children, it may follow a viral infection. Symptoms may include easy bruising, bleeding, and pinpoint-sized reddish-purple spots on the lower legs.
Idiopathic/immune thrombocytopenic purpura
White plaques on red base on the buccal mucosa and inside the oral cavity
Thrush (yeast, candidiasis)
Treatment for thrush
nystatin or diflucan
SJS has a distinct prodrome similar to
patch of hair loss in children
Treatment for tinea corporis
- topical therapy first choice (anti fungal like ketoconazole)
- use until lesions are gone + several days-1 week
- treat at least 1 niche beyond the edge of lesion
- don't cover with bandage
Impetigo often starts as what?
bug bite or skin injury
Diagnosis for HSV
- PCR is highly sensitive and specific
- gold standard = viral culture
A child has developed honey colored crusts around nose mouth and buttocks that are not getting any better. The best tx would be:
4. triple antibiotic
- < 4mm spots of bleeding under the skin
- capillary instability
- many causes- infectious most worrisome
diagnosis for tinea capitis (3)
- woods lamp exam
- fungal culture (toothbrush)
infantile seb derm usually resolves by ___ weeks
If infant presents with yellow greasy scales on scale, red patches on face and flexor surfaces, think
infantile seborrheic dermatitis
treatment for seb derm (2 main points)
- loosen scales with oil
- gently brush with shampoo containing selenium (dandruff)
- low dose topical steroids
this type of purpura affects the small blood vessels of the skin, joints, intestines, and kidneys.
Symptoms include reddish-purple spots on the lower extremities, swollen and sore joints, abdominal pain, or bloody urine.
treatment of early lyme disease in children >8 and < 8
>8: doxycycline is recommended agent, 2 mg/kg twice daily (maximum 100 mg dose)
<8 : doxy not recommended, could do amoxicillin 50 mg/kg per day in three divided doses (maximum 500 mg per dose) OR cefuroxime axetil 30 mg/kg per day in two divided doses (maximum 500 mg per dose)
If impetigo is anything BUT just a few close lesions, what would be the tx?
systemic treatment - cephalexin or dicloxacillin
staphylococcal scalded skin syndrome (SSSS) is most common in what populations (3)
- < 5 years old
If child presents with faint erythematous (almost eczematous) eruption beginning on central face, neck, axilla, groin and then becomes generalized erythema with blisters, plus fever and irritability and positive Nikolsky sign, this would be what?
Treatment for herpes zoster?
oral acyclovir in first 48-72 hours of illness
Treatment for SSSS?
IV antibiotics and supportive measures (ICU)
Ill-defined red plaques that are warm and tender, may have fever and regional lymphadenopathy - think?
Stevens johnson sydrome (SJS) and toxic epidermal necrosis (TEN) are most often caused by what?
meds: NSAIDS, sulfas, anticonvulsants
Treatment for folliculitis
may not require antibiotics
topical antibiotic therapy is usually sufficient: mupriocin or clindamycin
Treatment for eczema (5 main points)
1. moisturize! (vaseline, cetaphil, crisco, eucerin)
2. mild or mild-moderate topical corticosteroids
3. educate that its a chronic diease
4. bath 3-4x/week and wet wraps
5. can use antipruritics
Multiple grouped vesicles on an erythematous base along a dermatome (1 or a few), more of an itching sensation than pain
Dx for tinea corporis
KOH (culture not necessary)
treatment for Henoch-Schönlein purpura
Treatment for herpes - neonatal? Herpes labialis or whitlow? Herpetic gingivostomatitis?
neonatal - emergency, sepsis workup
Lab or Whitlow: antiviral with outbreak or prophylaxis
Gingivo: first 48 hrs antiviral, symptom management
treatment for tinea capitis (4 points)
- oral griseofulvin for one month at least
- eat fatty foods
- check CBC, LFTs every 4 weeks on therapy
- NO steroids or antibiotics for kerion
If impetigo is just a few close lesions, what would be the tx?
topical mupirocin or retapamulin
Treatment for seborrheic derm in the post-puberal population includes what 2 points?
- dandruff shampoo
- mild potency steroid at bedtime only
Open sores with honey-colored crusts and ooze would indicate
If child has grouped vesicles on an erythematous base, coalescent vesicles and erosions, and regional lymphadenopathy, suspect
if child has few-several vesicles that are shallow, punctuate ulcers on the attached gingiva, hard palate, and vermillion border (upper edge of lip) that have lasted for 1-3 weeks, would this be herpes stomatitis or aphthous stomatitis?
group of inherited disorders that affect your connective tissue (skin joints blood vessel walls). patients with this genetic disease classically often have overly flexible joints (and often have joint paint or dislocation) or stretchy, fragile skin.
treatment for SJS and TEN?
treatment for Idiopathic/immune thrombocytopenic purpura
usually resolves without any treatment
Most warts in kids are caused by viruses in what family
> 10 mm bleeding under the skin
SJS and TEN may mimic ___ in early course
3 main components of urticaria tx:
1. avoid allergen/bath to remove
2. oral antihistamines
3. cool compresses
main 4 causes of cellulitis
2. h influenza
3. staph aureus
A 2 year old presents with pustular, ulcerating lesions on hands and feet in addition to oral lesions. Child is irritable, well-hydrated and afebrile. Most likely dx?
1. Hand foot mouth
2. Aphthous stomatitis
3. Herpetic gingivostomatitis
4. scarlet fever
1. Hand foot mouth
is culture of area helpful with cellulitis?
Treatment strategies for warts
- immunologic (interferon, cimetidine)
non-inflammatory stage of tinea capitis lasts how long?
Treatment fr diaper dermatitis? (3 points)
- frequent changes
- NO WIPES -rins with water
- lubricating ointment may prevent overgrowth of yeast
Most common cause of rash in childhood
treatment for classic type Ehlers-Danlos syndrome includes
PT, OT, joint and muscle exercise and stabilization, anti-inflammatories, skin protection, cardiac monitoring, assessment for developmental delay or delayed motor milestones due to hypotonia
if diaper dermatitis lasts more than 3 days, may indicate
if child has one-a few ulcers with erythematous halos on the buccal mucosa, floor of mouth, oropharynx, vestibule, or tongue and have lasted 1-2 weeks would this be herpes stomatitis or aphthous stomatitis?
aphthous stomatitis (canker sores)
Treatment for scabies?
- permethrin 5% applied to every part of body under nails etc, leave on for 8-12 hours then rinse off, retreat in 1 week
treat family members
wash linens in hot water
does aphthous stomatitis (canker sores) clear on its own or require treatment? what is the care?
clear on their own
care includes local anesthetics, can include steroids or anti-inflammatories but mostly about numbing and pain relief
Most common cause of tinea capitis
examples of mild or mild-moderate topical corticosteroids that you might prescribe for a patient with atopic derm
LOWER MID STRENGTH
0.1% hydrocortisone or triamcinalone
A child with boggy nasal mucosa has voluminous clear discharge, dark circles under eyes and itchy erythematous papular red rash behind knees on wrist and AC areas. The diagnosis is:
2. atopic derm
3. tinea corporis
4. poison ivy
2. atopic derm
Are topical antibiotics or systemic corticosteroids indicated for eczema?
Treatment for Molluscum contagiosum
refer to derm
What is the most common cause of scaling scalp in post-pubertal population?
for impetigo, child should avoid school/childcare for how many hours?
until on antibiotics for 24 hours
Treatment for pediculosis (lice)
- retreat in 1 week
- remove nits with comb
- clean environment